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Home My WebLink About1000-79.-2-8 TOWN OF S Rental Permit Permit No. 0336 Owner Debra Farron Occupied as Single Family Dwelling Located at 5650 N. Bayview Road Southold 79-2-8 Village S/B/L Maximum Permitted Occupancy 9 : Is in compliance with all of the provisions of the code of the Town of Southold, the laws and sanitary and housing regulations of the County of Suffolk and by the laws adopted by the New York State Fire Prevention and Building Code Council. Expiration is two (2) years from date of issue. The operator is responsible for arranging for the bi-annual inspection. 9/16/2020 John Jarski Date of Issue Code Enforcement Officer This Notice must be posted by the main entrance at all times 4,4- , 0 so . . ; Town Hall Annex i Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLI) RENTAL PERMIT APPLICATION (� � , i� ,r Rental Permit Fee$200(Application must be renewed evetwo years) AUG 3 0 2019 -E Section A. Property Information: Rental Property 1�-c3 Tax Map Number: 1000 SECTION �� -BLOCK 9 -LOT SECTION B. OWNER INFORMATION: Property Owner Name: Property Owner Legal Address: Property Owner Mailing Address: 10 2-eO Telephone Number(s): Daytime Evening Emergency (,o 3 3 ` (S.9,9 0 Property Owner Email Address: v = 0 r 0 Page 1 of 5 40o SOUTH®�a Town Hall Annex , Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 Y Y4 Southold,NY 11971-0959 l�Crum BUILDING DEPARTMENT TOWN OF SOUTHOLD f RENTAL PERMIT APPLICATION INSTRUCTIONS Rental Permit Fee $200 (Application must be renewed every two years) The items listed below are required to be submitted with the completed application. Ci Floor Plans: Floor plans of each Rental Dwelling Unit, please show location of all smoke &carbon monoxide detectors. "Ce ificates of Occupancy and Pre-Certificates of Occupancy: Certificates of occupancy or Pre-Certificates of Occupancy for each rental dwelling unit. ❑ Certification of Code Compliance(form enclosed): Must be submitted by a license architect or engineer or license home inspector if an inspection by Town of Southold Inspector is declined. /Rental Permit Fee: $200.00 oF S° , Town Hall Annex Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 9Z Southold,NY 11971-0959 a Q BUILDING DEPARTMENT TOWN OF SOUTHOLD Section C. Authorized Agent Information: Name of Authorized Agent of dwelling unit, if any: sts Address of Authorized Agent (no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number(s): Daytime Evening Emergency Email Address: Section D. Managing Agent Information: Name of Authorized Agent of dwelling unit, if any: Address of Authorized Agent(no P.O. Boxes): Mailing Address of Authorized Agent: Telephone Number(s): Daytime Evening Emergency Email Address: SECTION E. SITE MANAGER INFORMATION:(required for rental properties containing 8 or more rental units) Name of Managing Agent of dwelling unit, if any: Address of Managing Agent (no P.O. Boxes): Page 2 of 5 'c�� soUry�� Town Hall Annex Telephone(631)765-1802 54375 Main Road , Fax(631)765-9502 P.O.Box 1 179 5� �Q Southold,NY 11971-0959 �c®U ,� �},�� BUILDING DEPARTMENT TOWN OF SOgJTHOLD Mailing Address of Managing Agent: Telephone Number(s): Daytime Evening Emergency Email Address: SECTION F. PROPERTY DESCRIPTION: Number of Rental Dwelling Units on property: \ o n(,) For each Rental Dwelling Unit set forth the Rental Dwelling Unit identifier(for example, Unit 1, Unit 2, Unit 3 or Apt A, B, Q the use of each room in the Rental Dwelling Unit (for example, Kitchen, Bedroom 1, Bedroom 2, Living Room) and the dimensions of each room. For properties with multiple Rental Dwelling Units use "Rental Permit Application Addendum." Rental Dwelling Unit Identifier: Requested Maximum number of persons allowed to occupy Dwelling Un t: 'co� Number of rooms in Rental Dwelling Unit: Use and Dimensions of each room in Rental Dwelling Unit: 16 iy i y7 " 1✓f-� g x J L `�►r' ✓� � `1 l� X ( 1 J Page 3 of 5 139— I� /D _sau��® '�, Town Hall Annex �® Telephone(631)765-1802 54375 Main Road Fax(631)765-9502 P.O.Box 1179 I Southold,NY 11971-0959p!` c®U a BUILDING DEPARTMENT TOWN OF SOUTHOLD SECTION G. INSPECTION: Pursuant to the Town Code of the Town of Southold Chapter 207 (Rental Properties), a safety inspection by Code Enforcement Official is required. If the owner chooses not to have said inspection performed by the Town, a certification from a licensed architect, a licensed professional engineer or a home inspector who has a valid New York State Uniform Fire Prevention Building Code Certification is required stating that the property which is the subject of the rental permit application is in compliance with all of the provisions of the code of the Town of Southold,the laws and sanitary and housing regulations of the County of Suffolk and by the laws adopted by the New York State Fire Prevention and Building Code Council. V11 am requesting a fire safety inspection to be performed by a Code Enforcement Official from the Town of Southold ❑ 1 am submitting a completed Town of Southold certification form from a licensed architect or a licensed professional engineer. SECTION H. DECLARATION: Signature must be notarized and MUST be the owner of the dwelling unit. STATE OF NEW YORK) ) COUNTY OF SUFFOLK) I certify under penalty of perjury,the following: j 1. 1 am the owner of the property identified in "Section A"of this application. 2. The property owner's legal address set forth in "Section B" of this,application'is my legal address and I understand the Town will use the address for service pursuant to all Page 4 of 5 so v Town Hall Annex Telephone(631)765-1802 54375 Main Road ; Fax(631)765-9502 P.O.Box 1179 �, r , eC Southold,NY 11971-0959 BUILDING DEPARTMENT TOWN OF SOUTHOLD applicable laws and rules. I further acknowledge that I will notify the Town of Southold Building Department of any changes of address within five (5) days of any changes thereto. 3. 1 have read and received a copy of Chapter 207 of the Code of the Town of Southold and agreed to abide by the same. 4. 1 will notify the Town within five (5) business days as to any change to the information regarding Authorized Agent, Managing Agent, or Site Manager. Property Owner's Name:—h ,� Property Owner's Signature: IQ ,� ,� - ----� Sworn to Pefore me this day of .., 20 `7 K—°-1 Official Notary qublic Signature and Original Notary Stamp Notary Pub"c,State of NDA M.RUDDER w York Quainf ed m gufr20932 olk County Commission Expires March 8,20&D-) Page 5 of 5 VORK NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N. Y. L t'q'+ CERTIFICATE OF OCCUPANCY No. .......a.1262....... Date ........ ... .......jr1knuary'..23........ 9.�. THIS CERTIFIES that the building located MapNo.**... .............. Block No. .."*... ....... Lot No ................. ........................................... conforms substantially to the Application for Building Permit heretofore filed in this office dated .•.. :1.1mir...2I%....................... .. 19.49, pursuant to which Building Permit No. $...931.... dated ... 19....S.S, was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is .......... . ..... .. . i t •.• .. `+ •Ii••ti K98L�3i#...... ......................................................................... This certificate is issued to ............4.9hark-9. ..xCq--%My.A.APpj 4.. :r... c.r.? F ?yr.. (owner, lessee or tenant) of the aforesaid building ........... .........Building Inspect r...................... . 1 FORK NO. 1, TOWN OF SOUTHOLD BUILDING DEPARTMENT Town Clerk's Office Southold, N. Y. Certificate Of Occupancy No. $0.0.07. . . . . . Date . . . . . . . . . . . .J ! . . . 8 . . . . ., 19.7. THIS CERTIFIES that the building located at . . . W/S P• Road to BdTtitreet Map No. . .9. . . . . . . . Block No. . . ? . . . . .Lot No. . . . . . So%tbold. . . . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . . . . . . . . .July. . 1.7. ., 19- 14 pursuant to which Building Permit No. . . . ? dated . . . . . . . . . . . July. . .18. ., 19- 14,4, was issued, and conforms to all of the require. ments of the applicable provisions of the law. The occupancy for which this certificate is issued is . . .bAY49 u91k:s9r7 _(Oprae The certificate is issued to . . . .Rohert. XcCartby (owner, lessee or tenant) of the aforesaid building. Suffolk County Department of Health Approval N•8r. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE No. . .K•RA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . HOUSE NUMBER . . .5650. . . . . . . Street . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Buil ' g Inspector FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold,N.Y. Certificate Of Occupancy Date . . . . .30,p.t YAtp,.V . 16. . . . .. . . . THIS CERTIFIES that the building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . Location of Property 5.63R. . . . . . . . . . .NQr h. o d ;o Bayview . . . . . . . . Southold. . House No. S eei ' � Hamlet County Tax Map No. 1000 Section .0 79. . . . . . . Bloch . .Q 2. . . . . . . . . . .Lot . . . . .0Q0. . . . . . .. . Subdivision . . . . . .:C . . . . . . . . . ... . . . . . . . . . . . . .Filed Map No. . . . . . .Lot No. A . . . . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated 19$?.pursuant to which Building Permit No. . 1.1,i 65. Z . . . . . . . . . . . dated . . . . . 1113 . Q. . . . . . . . . . . . . . : 19 . ?,was issued,and conforms to all of the requirements of the applicable provisions of the law.The occupancy for which this certificate is issued is . . . . . . . . . .. . . . . . A .deck, .addi,tton, to.an existing. dwelling.. . . . . . . . . . . . . . . . . . . The"certificate is issued to . . . . . . .Rohert. .J MQaa. A, &p.QElrtby. . . . . . . . . . . .. . . . . . (owner,,/ease*,of*&m&ndl of the aforesaid building. Suffolk County Department of Health Approval . . . . . 11/a. . . . . . . . . . . . . . . . . .. . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . . . .nla. . . . . . . . . . . . . . . . . ... . .. . . . . . . . . . . . of . . . . . . . . . . . . . . . . . . . . . . . . . . Building Inspector Rev.IM R FORM NO.4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. Certificate Of Occupancy No. .2;1344.-2. . . . . . . . . Date . . . .. . . . . . .May.14. . . . . . . . . . . . . 19 85 THIS CERTIFIES that the building_..,�ccegsory, ,building , , , , , , , , , , , , , , , , , , , , , , , Location of Property .5,650, , . . . , , . , . .North Road to pp .i.ew Southold House No, Street llamlei County Tax Map No. 1000 Section . . . . . . .Block . . . . . .02. . . . . . .Lot . . 008, . . , . . Subdivision . . . . . . . .X. . . . . . . . . . . . . . . . . . . . . .Filed Map No. . . . . .Lot No. . . . , . . . . . . . . conforms substantially to the Application for Building Permit heretofore filed in this office dated . . .17axch. R . . . . . . . . 1984, pursuant to which Building Permit No. . '1.2923 .Z. , , , , , , , , , dated . . . . . .NaXo a.. .8 . . . . . . . . . . . . . 19$4. ,was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is . . . . . . . . . . . . . . . axe_.acP-essDuy.bnilding. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The certificate is issued to . . . . ROBERT.McCARTHY (owner,�tess�rt�nanrJ of the aforesaid building. Suffolk County Department of Health Approval . . . WE. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UNDERWRITERS CERTIFICATE NO. . . . . . . . . . . 11./.z'. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ;t & a•.- 01-1 Building Inspector Rev.1/81 M� S rl OGT / # 'x' TOWN 'OF SOUTHOLD BUILDING DEPT. a `ycvurm��'' 765-1802 -INSPECTION- FOUNDATION INSPECTION FOUNDATION 1ST [ ` ] ROUGH PL13G. [ ] FOUNDATION 2ND= [ ] INSULATION/CAULKING [ ] FRAMING /STRAPPING [ ] INAL JJ�� [ ] FIREPLACE& CHIMNEY [ ` FIRE-SAFETY INSPECTION [ ] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION- ELECTRICAL ENETRATION- ELECTRICAL- (ROUGH) [ ] ELECTRICAL (FINAL) [ ] CODE VIOLATION [ ] PRE C/O REMARKS: r L DATEWWIIINSPECTOR f _ 1 11 ((� I L i1 1 1 H I 1 111 1 .. — l_ i I ! I kl_I - ; 1 81 1 1 TI l___', L o, ie i ► �- I LLFWI �- 1 - I l l l i l l l l l i CFO V�Al k AN R Nil 05- I&J J- LO I I ILI I1 llI �� f II i 1 191 1 1 H_ 1 ► 1 1 11 1 1I El► , , , ell- 1 , I I IL I I "r I TOWN OF SOUTHOLD M,l STREET VILLAGE DISTRICT SUB. LOT Li OWNER ��f _ E AC AGE - FORMER.OWNER , \h J-0T-QnZt '� �> n 1 IR � ``` . x'5 c C1f vv.( 14-jS f W C+k� TYPE OF BUILDING �� c tc- R SEAS. VL. F R 1 • .. .: , cowe {lt�1D. CB. J MESO. `."`•_• ��' r u b ��,)6 �-e�� LAN 11V�P. TOTAL BATE REMAR S fJ V w 96-►Ln :3 cn { .c 6 641%11) 344 sir. .ct�c ora `` AGE V co BU MING ND1TION r 27— eAY" {. -3 V o o RhrlAL B W Z� v 00 ABOVE '--j L 6 z 1. �� Farm Acre Value Per Acrb Value = y 0Lo Ti l f able l ro i L Lo Til(oble 2 Lo Tillable. 3 Woodland Swamplan4 AUG o, BrusMand m - C*4 House Flat w Tata I f �� f ti f ,i, i C d1Y�L,•�x_�• ry.. f u� � • .�.. =E,WImom �v ■i■iii■■iii■■i■i!■ice _ .� t�:::�� i!!!!■0l■1■fir■■■■■■■■ Ids, 0 ME 777 ■■■■■i'■i■■■■i■■■■m!■ ■!■ Viimom■■}w■!■■■■■ nlili■;■■■■ii■■■■■ilim ■i�l�r■i ■■�■■■mom mom NNE NONE ■■ SPIRO man" l MIlPil [nterior Finish Patio i ■ L� .f J \. a�pS�FF�I'�coG.� Town'of Southold 9/16/2020 !tA P.O.Box 1179 co 53095 Main Rd �PIN�' Southold,New York 11971 I I CERTIFICATE OF OCCUPANCY No: 41447 Date: 9/16/2020 THIS CERTIFIES that the building WINDOWS Location of Property: 5650 N Bayview Rd, Southold SCTM#: 473889 Sec/Block/Lot: 79.-2-8 Subdivision: Filed Map No. Lot No. conforms substantially'to the Application for Building Permit heretofore filed in this office dated 8/31/2020 pursuant to which Building Permit No. 45199 dated 9/14/2020 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is: "as built"window reolacement and electric service as applied for. The certificate is issued to Farron,Debra of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL ELECTRICAL CERTIFICATE NO. 45199 9/15/2020 PLUMBERS CERTIFICATION DATED coo ognature